You will be advised of the recommended diagnostic procedures and associated costs before proceeding with a treatment plan for your pet. Payment is required at the same time your pet is discharged from the hospital. If your pet requires hospitalization, a minimum pre-payment of 100% of the high end estimated charges is required. By signing below, I authorize Dogs & Cats Emergency & Specialty to charge my credit card or other payment method on file for any remaining balance due, if no other form of paymentis provided.
I understand that any balance remaining after discharge of my pet, if not collected within 30 days, may be placed in collections with a third party. I accept responsibility for payment of any fees associated with collections, including the reasonable attorney's fees and
I am the owner of the above described pet, or, am acting as an agent and have authorization from the owner to consent to the pet's treatment. I am at least 18 years of age. PHOTO ID REQUIRED- PLEASE ATTACH BEFORE FORM SUBMISSION I accept full financial responsibility for the services provided.